Acne Vulgaris - Dr Colin Hong

Acne vulgaris is a skin condition that affects millions of people around the world. It occurs when oil, dead skin cells and bacteria block hair follicles, resulting in blackheads, whiteheads, pimples and cysts. While it is most common among adolescents, it can affect adults too. Fortunately, there are a number of treatments available to help clear up Acne Vulgaris and reduce the symptoms associated with it.

Here, we will discuss the causes of acne vulgaris as well as some of the most effective treatment options available. We’ll also provide some tips on how you can protect your skin from developing acne in the future. So if you’re looking for answers on how to manage your acne, read on!

History and Definition

Acne vulgaris is an inflammatory skin disorder that affects the oil glands and hair follicles of the face, chest, and back. It is one of the most common skin conditions among people aged 11–30 years old. Symptoms can include pimples, blackheads, and cysts. If left untreated, acne can cause long-term physical and emotional damage – from scarring to depression/anxiety.

The term “acne vulgaris” was first used by Fuchs in 1840 to describe a common skin condition which has since been documented as far back as 3400 BC in the Ebers Papyrus. In modern times, there are many theories about what causes acne vulgaris but the most popular explanation suggests it is a combination of genetics, hormones and bacteria.


Acne vulgaris is a skin condition that commonly affects the face, neck, chest and back. The main symptoms of acne vulgaris are:

  • Whiteheads: Whiteheads form when oil and dead skin cells become trapped in the hair follicle beneath the surface of the skin. 


  • Blackheads: Blackheads occur when the clogged pores open up to the air causing oxidation which turns them black. 


  • Papules: Papules are inflamed lesions that appear as small pink bumps on the skin’s surface.


  • Pustules: Pustules are similar to papules but they have a yellowish-white center filled with pus. 


  • Nodules: Nodules are large, painful lumps beneath the surface of the skin caused by inflammation deep in the hair follicles. 


  • Cysts: Cysts are the most severe type of acne and consist of large, pus-filled lumps beneath the surface of the skin that can cause extensive scarring. 


The exact cause of acne vulgaris is not known, but it is thought to be related to changes in hormone levels during puberty. Other factors that can contribute to acne are:

  • genetics 
  • stress 
  • environmental triggers such as pollution and humidity 
  • frequent skin picking or scrubbing; and 
  • the use of certain cosmetics or medications 
  • Hormonal fluctuations due to pregnancy or taking birth control pills can also trigger outbreaks. 

Acne is more common in people with oily skin types because excess oils on the skin can provide an ideal environment for bacteria growth. Additionally, hormonal imbalances or increased levels of androgens (male hormones) may contribute to the development of acne lesions. 

Allergens have also been implicated in some cases. In general, when sweat and oil accumulate on the skin, bacteria can grow and cause inflammation which leads to acne. Treatment from a qualified dermatologist or plastic surgeon can help identify what is causing your outbreak and provide recommendations for managing or preventing further episodes.


Acne vulgaris is typically diagnosed through a physical examination of the skin and medical history. The diagnosis may be confirmed with the following steps:

  • A thorough examination of the skin to assess the type, location, and severity of the acne


  • Review of the individual’s medical history, including any previous treatments for acne and current medications


  • Evaluation of any underlying medical conditions that may be contributing to the acne


  • Discussion of the individual’s skincare routine and diet.

In some cases, a skin culture or biopsy may be required to rule out other skin conditions.


Treatment for acne vulgaris may include:

  • Topical medications such as retinoids, benzoyl peroxide, and antibiotics
  • Oral medications such as antibiotics, hormonal agents, and isotretinoin
  • Light and laser therapy
  • Chemical peels
  • Microdermabrasion

There is no specific test for acne vulgaris, as the condition is typically diagnosed through a physical examination of the skin and medical history.

Surgical Treatment

Surgery is not a common treatment for acne vulgaris, as the condition is typically managed with topical and oral medications. In severe cases, a surgical procedure known as acne excision may be performed to remove deep-seated cysts or nodules.

During an acne excision, a local anesthetic is administered and the cyst or nodule is removed using a scalpel or needle. Stitches may be necessary to close the wound.

After the surgery, the individual can expect some swelling and redness at the incision site, which should subside within a few days. It is important to keep the incision site clean and to avoid picking or scratching at the wound to prevent infection and scarring. The individual should follow their doctor’s instructions for wound care and attend any follow-up appointments as recommended.

It is important to remember that while surgery may provide some relief from severe acne, it is not a cure and ongoing management of the condition may still be necessary.

Risk Factors

Risk factors for developing acne vulgaris include:

  • Hormonal changes, such as during puberty, menstrual cycles, pregnancy, or menopause
  • Family history of acne
  • Greasy or oily cosmetic products and hairstyling products
  • Certain medications, such as corticosteroids, lithium, and androgens
  • Poor diet and a high glycemic index
  • High-stress levels
  • Smoking
  • Use of anabolic steroids
  • Humid or hot weather
  • Squeezing or picking at acne lesions.


Complications of acne vulgaris can include:

  • Scarring: Acne can cause scarring, which can be permanent and disfiguring.


  • Dark spots: Acne can cause dark spots, which may take months or years to fade.


  • Emotional distress: Acne can have a significant impact on a person’s emotional well-being, causing low self-esteem, anxiety, and depression.


  • Infection: Picking or squeezing acne lesions can increase the risk of infection.


  • Hormonal imbalances: In women, acne can be a symptom of hormonal imbalances such as polycystic ovary syndrome (PCOS).

It is important to seek acne treatment as soon as possible to minimize the risk of these complications and improve overall skin health.

When to See a Doctor

It is recommended to see a doctor for acne vulgaris if:

  • Over-the-counter treatments are not effective
  • The acne is painful or causes significant discomfort
  • The acne is spreading or getting worse
  • The acne is affecting daily activities and quality of life
  • The acne is causing scarring
  • The individual has concerns about their skin or wants a professional opinion
  • The individual is pregnant or considering pregnancy and wants to discuss safe treatment options.

A doctor can provide a proper diagnosis, recommend a customized treatment plan, and monitor the individual’s progress to ensure the best possible outcome. Early treatment can help to minimize the risk of complications and improve the overall appearance of the skin.

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With proper treatment, acne vulgaris can be effectively managed and the risk of complications minimized.


Schedule an appointment with a dermatologist or plastic surgeon to discuss your acne symptoms and receive a proper diagnosis.

Medical History Review

The doctor will review your medical history, including any previous treatments, medications, and underlying health conditions that may be contributing to the acne.

Physical Examination

The doctor will perform a physical examination of your skin to assess the type, location, and severity of the acne.

Treatment Plan

Based on the examination and medical history review, the doctor will develop a personalized treatment plan for your acne.

  • Topical and/or Oral Medications: The doctor may prescribe topical or oral medications to help clear the acne, such as retinoids, antibiotics, and isotretinoin.
  • Light and Laser Therapy: In some cases, the doctor may recommend light and laser therapy to reduce inflammation and promote healing.
  • Chemical Peels: Chemical peels may be recommended to help exfoliate the skin and improve the appearance of acne scars.
  • Microdermabrasion: Microdermabrasion may be recommended to remove dead skin cells and promote skin rejuvenation.

  • Surgery: In severe cases, the doctor may recommend surgical removal of deep-seated cysts or nodules.

Follow-Up Appointments

The doctor will schedule follow-up appointments to monitor your progress and adjust your treatment plan as needed.


Acne vulgaris is a common skin condition that can cause physical and psychological distress for many individuals. Although its exact cause is unknown, it typically occurs due to the overproduction of oil in the sebaceous glands, combined with bacteria and inflammation of the follicles. While there are effective treatments available—such as topical medications and oral antibiotics—it’s important to use caution when choosing an acne regimen. 

Ultimately, understanding what may be triggering an outbreak can help prevent future flare-ups. Acne vulgaris affects millions of people around the world and with proper diagnosis, management, and lifestyle changes, it’s possible to control or even eliminate this chronic skin disorder.


Dr. Colin Hong is one of the leading plastic surgeons in Toronto, with over 35 years of experience, who specializes in high-quality cosmetic, plastic and reconstructive surgeries, at an affordable cost. He understands the importance of effective treatment and will work closely with you to develop a plan that meets your individual needs and goals.

If you are interested in receiving treatment for acne vulgaris from Dr. Colin Hong, please contact his office at (416) 222-6986 or email us at to request a consultation today. Please leave your full name, email address and phone number so we can reach you promptly. Additionally, please obtain a referral from your family doctor before requesting an appointment with Dr. Hong.

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